Wellcare Giveback (HMO-POS)
$0.00 /month
Monthly Premium
Among the lowest-premium plans in 2026
$615.00
Annual Deductible
930
Drugs Covered
1
States Served
Top Covered Drugs
Most popular medications covered by this plan, ordered by national search frequency. Click any drug to see exact copay, restrictions, and alternatives.
| # | Drug Name | Type | Tier | 30-Day Copay | |
|---|---|---|---|---|---|
| 1 | Scopolamine scopolamine | Brand | Tier 4 | 0.4% coinsurance | Details |
| 2 | Dicyclomine Dicyclomine hydrochloride | Brand | Tier 4 | 0.4% coinsurance | Details |
| 3 | Levothyroxine Sodium levothyroxine sodium | Brand | Tier 1 | $0.00 | Details |
| 4 | PedvaxHIB Haemophilus b Conjugate Vaccine (Meningococcal Protein Conjugate) | Brand | Tier 6 | $0.00 | Details |
| 5 | Daurismo glasdegib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 6 | Enoxaparin Sodium Enoxaparin sodium | Brand | Tier 4 | 0.4% coinsurance | Details |
| 7 | ISENTRESS RALTEGRAVIR | Brand | Tier 5 | 0.3% coinsurance | Details |
| 8 | Amoxicillin and Clavulanate Potassium | Brand | Tier 2 | $0.00 | Details |
| 9 | Lenalidomide | Brand | Tier 5 | 0.3% coinsurance | Details |
| 10 | Warfarin Sodium | Brand | Tier 1 | $0.00 | Details |
| 11 | Nystatin | Brand | Tier 2 | $0.00 | Details |
| 12 | Fiasp insulin aspart injection | Brand | Tier 3 | 0.3% coinsurance | Details |
| 13 | Augtyro repotrectinib | Brand | Tier 5 | 0.3% coinsurance | Details |
| 14 | Paxlovid nirmatrelvir and ritonavir | Brand | Tier 3 | 0.3% coinsurance | Details |
| 15 | Emtricitabine and Tenofovir Disoproxil Fumarate | Brand | Tier 4 | 0.4% coinsurance | Details |
| 16 | Acamprosate Calcium acamprosate calcium enteric-coated | Brand | Tier 2 | $0.00 | Details |
| 17 | Phenobarbital | Brand | Tier 2 | $0.00 | Details |
| 18 | Diazepam | Brand | Tier 2 | $0.00 | Details |
| 19 | Atomoxetine | Brand | Tier 2 | $0.00 | Details |
| 20 | Fetzima LEVOMILNACIPRAN HYDROCHLORIDE | Brand | Tier 3 | 0.3% coinsurance | Details |
Showing 20 of 930 covered drugs.
States Served (1)
This plan is available to Medicare beneficiaries in the following states.
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